| NPI | 1730500489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT PUCKETT VP 904-634-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2022-12-12 |